Clinical Case Database / Category: Clinical Care

Management of acute stroke

Publication details

Dr Katherine Athorn MBChB MRCP, Joanna Corrado, Dr Oliver J Corrado MBChB FRCP(Lond)
Foundation Years Journal, volume 2, issue 6, p.281 (123Doc Education, London, July 2008)


An 80-year-old woman was found lying on the floor by her daughter and when the paramedics arrived, her eyes were deviated to the left, she had a right-sided hemiparesis, with a Medical Research Council (MRC) grade 1/5 weakness of the upper and lower limb and she was aphasic. There was no evidence of head injury. She was in sinus rhythm with a rate of 80 beats per minute, blood pressure of 170/100mmHg and capillary glucose of 5.7mmol/L. There were no bruits or murmurs audible on examination and she had no abnormalities on respiratory or abdominal examination. You are called to assess the patient in the emergency department.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Dr Katherine Athorn MBChB MRCP

SpR Geriatric Medicine
Leeds General Infirmary
Great George Street

Joanna Corrado

Year 4 Medical Student
University of Manchester Medical School

Dr Oliver J Corrado MBChB FRCP(Lond)

Consultant Physician
Leeds General Infirmary and
Director of the West Yorkshire Foundation School


1. NICE. Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack 2008, Developed by the National Collaborating Centre for Chronic Conditions.
2. The Intercollegiate Working Party for Stroke. National Clinical Guidelines for Stroke. 2000 London: Royal College of Physicians.
3. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bulletin of the World Health Organization 1976 54:541-553.
4. Bath PMW, Lees KR. ABC of arterial and venous disease: acute stroke. British Medical Journal 2000 320:920-923.
5. National Audit Office. Reducing Brain Damage: faster access to better stroke care 2005 (HC 452 Session 2005-2006). London: NAO.
6. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974 2:81-84.
7. Mann G, Hankey GJ, Cameron D. Swallowing disorders following acute stroke: prevalence and diagnostic accuracy. Cerebrovascular Dis 2000 10:380-386.
8. Warlow C, Sudlow C, Dennis M, et al. Stroke. Lancet 2003 362:1211-1224.
9. North American Symptomatic Carotid Endarterectomy Trial collaborators. Beneficial effects of carotid endarterectomy in symptomatic patients with high grade stenosis. N Engl J Med 1991 325:445-453.
10. Bamford J, Sandercock P, Dennis M, et al. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991 337:1521-1526.
11. Mead G, Lewis S, W ardlaw J, et al. How well does the Oxfordshire Community Stroke P roject classification predict the site and size of the infarct on brain imaging? J Neurol Neurosurg Psychiatry 2000 68: 558–562.
12. Warlow C, van Gijn J, Dennis M, et al. Stroke: Practical Management. 3rd edn, 2008. Oxford: Blackwell Publishing.
13. Hankey G. Clinical Update: management of stroke. Lancet 2007 369: 1330-1332.
14. Stroke Unit Trialists’ Collaberation 1997. Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. BMJ 1997 314:1151-1159


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.